It is of great importance to prevent obesity before it occurs. Prevention of obesity should start in childhood. Obesity that occurs during childhood and adolescence lays the groundwork for obesity in adulthood. Therefore, family, school and the environment should be informed about adequate and balanced nutrition and physical activity. Obesity treatment is a compulsory, long and continuous process that requires the determination and active participation of the individual. The fact that many factors are at the root of obesity makes the prevention and treatment of this disease extremely difficult and complex. For this reason, in obesity treatment, the candidate who is determined to lose weight, family members who will support this issue, Endocrinologist, Dietitian, Obesity Surgeon, Anesthesiologist experienced in Obesity Surgery, Experienced surgery team.
When necessary; A team such as a specialist psychologist, internal medicine, cardiology and chest diseases specialist is required.
The aim of obesity treatment is to reduce the risks of obesity-related disease (morbidity) and mortality by targeting a realistic body weight loss and to provide adequate treatment to the individual. and to gain balanced nutrition habits and improve the quality of life. Reducing body weight by 10% in a 6-month period provides significant benefits in preventing health problems caused by obesity.
Methods used in obesity treatment are grouped under 4 groups. These methods:
1. Medical nutrition (diet) treatment,
Medical nutrition therapy plays a key role in the treatment of obesity. With nutritional treatment in obesity:
· It should be aimed to reduce body weight to the level required according to height (BMI = 18.5 – 24.9 kg/m2). It should not be forgotten that medical nutrition (diet) treatment is specific to the individual. The targets set at the beginning may be the individual's ideal weight, or they may be slightly above the ideal weight.
· The slimming diets to be applied must be compatible with the principles of adequate and balanced nutrition. The aim is to provide the individual with correct eating habits and maintain this habit.
· Body weight should be according to height. When it reaches the minimum (BMI = 18.5 – 24.9 kg/m2), weight gain should be prevented and the lost weight should be maintained.
2.Exercise treatment
It is definitely accepted that physical activity reduces fat tissue and abdominal fat and prevents muscle mass loss that can be seen when dieting. With exercise therapy, which supports medical nutrition therapy, weight gain of individuals can be prevented and weight loss and weight regain can be prevented.
It is recommended that adults do moderate intensity exercise for an average of 30 minutes every day. This level of activity provides daily energy consumption of 840kj (200kcal). Obese people aim to be physically active every day. Energy expenditure varies depending on the person's body weight and activity intensity.
The basic principles of exercise therapy are stated below:
· Type of Exercise; Walking, Increase in Daily Living Activities, Resistance Exercises
· Frequency of Exercise; Every day or at least 5 days/week
· Duration of Exercise; 40-60 min/1 time a day, 20-30 min/2 times a day
· Exercise Intensity; 50-70% of Maximal Oxygen Consumption
The most important issues to be considered in the implementation of the exercise program in an obese individual are to keep the risk of injury at the lowest level while increasing energy expenditure. The recommended exercise program should be specific to the individual, fun, applicable and compatible with the individual's daily life habits.
3.Behavior change treatment
Behavior change treatment in the control of body weight, eating and physical activity that cause excessive weight gain It is a form of treatment that aims to change or reduce negative behaviors related to anxiety in a positive way and to reinforce positive behaviors so that they become a lifestyle. Steps of behavior change treatment:
1. Self-observation
2. Stimulus control
3. Lower Developing alternative behavior
4. Reinforcement, self-reward
5. Cognitive restructuring
6. Social support
4.Surgical treatment
Surgical approach to obesity is basically divided into two. The goal of bariatric surgery to reduce the energy intake from food is to reduce the absorption of nutrients in the gastrointestinal tract. For this purpose, gastric bypass, Slevee Gastrectomy, Gastric Banding, Gastric Balloon, etc. methods are used. The aim of reconstructive surgery is; It is the removal of existing fat tissues localized in various parts of the body. This treatment is focused on aesthetics and if the patient does not fulfill the requirements of obesity treatment, fat accumulation occurs again.
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